@article{oai:niigata-u.repo.nii.ac.jp:00006388,
 author = {Nishikura, Ken and Watanabe, Hidenobu and Iwafuchi, Mitsuya},
 issue = {4},
 journal = {Acta medica et biologica, Acta medica et biologica},
 month = {Dec},
 note = {Background: Endocrine cell tumors of the gastrointestinal tract are divided into the carinoid tumor (CD), a low-grade malignancy, and endocrine cell carcinoma (ECC), a high-grade malignancy. In this study, nuclear morphometry and proliferating cell nuclear antigen (PCNA) immunohistochemistry were performed to distinguish objectively between CDs and metastasizing CDs or ECCs. Methods: Nuclear morphometry and PCNA immunohistochemistry were performed on the following colorectal endocrine cell tumors: 15 primary CDs and 1 metastatic focus, 5 primary ECCs and 3 metastatic foci, and their counterparts of 5 solid adenocarcinomas and 3 metastatic lesions. To differentiate the tumors from one another and to elucidate which features are responsible for metastasis in CDs. Results: Nuclear morphometric values (area, circumference, and short diameter) significantly increased in the order of CDs, ECCs, and adenocarcinomas, and were positively correlated with the PCNA index (PI) and particularly with a PI of strongly positive cells (PI-S). The PI and PI-S significantly increased in the order of CDs, ECCs, and adenocarcinomas (p <0.01). A 20.0 x 17.0 mm CD, which extended down into the muscle layer metastasized to the lymph nodes and liver, contained a high-grade atypical (HGA) area. The HGA area, 10.6 mm^2 located in the submucosa, showed nuclear morphometric values quite similar to those of a nodal metastatic lesion, and its PI and PI-S were significantly higher than in the remaining primary CD area, but lower than in ECCs. Conclusions: Nuclear morphometry and PCNA index are useful for distinguishing CDs from more malignant CDs or ECCs, and for detecting the progressive potentiality of CDs.},
 pages = {143--151},
 title = {PCNA Index and Nuclear Morphometry for Diagnosing Higher Malignancies of Endocrine Cell Tumors in the Large Intestine},
 volume = {45},
 year = {1997}
}